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<title>STIFORP INDONESIA</title>

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<div style="text-align: right;font-weight: bold;color: white;padding-right:10px;padding-top:5px;padding-bottom:5px">Welcome to Nikolas Pabubungan IndoNetwork's site!</div>
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 <form action="/save#form" method="post" name="PRE">
 <input name="ENROLLER" value="1915095" type="hidden">
 <input name="SOURCE" value="IndoNetwork" type="hidden">
 <input name="ENROLLER_NAME" value="Nikolas Pabubungan IndoNetwork" type="hidden">
 <input name="PAGE" value="8" type="hidden">
 <input name="LANGUAGE" value="en" type="hidden">

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  <td width="31%" class="formText"> First&nbsp;Name:</td>

  <td width="69%">
   <input name="FNAME" maxlength="20" size="20" value="" type="text">
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  <td width="31%"  class="formText">Last&nbsp;Name: </td>
  <td width="69%">
   <input name="LNAME" maxlength="20" size="20" value="" type="text">

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  <td  class="formText"> Email:</td>
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   <input name="EMAIL" size="20" maxlength="60" value="" type="text">
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  <td width="31%"  class="formText">Confirm Email:</td>
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    <input name="EMAIL_C" size="20" maxlength="60" value="" type="text">
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  <td width="31%"  class="formText">Phone:</td>

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   <input name="PHONE" size="20" maxlength="20" value="" type="text">
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  <td>&nbsp;</td>
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 <td style="color:white"><center><a href="privacyPolicy" target="_blank" style="color:white">Privacy Policy</a> | <a href="javascript:go()" style="color:white;font-weight:bold">Click Here to Help Us Fight Spam!</a></center></td>
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